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Volume 12 Issue 2 ( April- June) 2023

Original Articles

An observational study on the clinical characteristics, maternal and perinatal outcomes of COVID 19 in a tertiary care centre during November 2020 to October 2021 (second wave)
Dr.SDivya, Dr.SVRThenmozhi,Dr.Shri JananiR, Dr.P.Vairamala, Padmanaban Srinivasan

Introduction:With over a million individuals infected, the global pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 has been growing at an accelerating rate. The increasing mortality rate warrants identification and protection of the vulnerable populations in society. The knowledge gained from previous human coronavirus outbreaks, namely, the severe acute respiratory syndrome coronavirus(SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV), suggests that pregnant women and their fetuses are particularly susceptible to poor outcomes. The aim of this systematic review was to report pregnancy and perinatal outcomes of coronavirus spectrum infections, and particularly coronavirus 2019 (COVID-19) disease because of severe acute respiratory syndrome-coronavirus-2 infection during pregnancy.Aim:To observe the maternal outcomes of COVID 19 During the second wave of COVID 19 and to determine the fetal Outcomes of COVID affected Mothers and to Study the clinical Characteristics of COVID Pneumonia in Pregnant mothers.Methodology:At admission of the patients detailed history of maternal and COVID symptoms is taken. Their clinical parameters such as saturation and blood pressure were monitored.Periodic clinical assessment of their liquor status, placentation and fetal heart was done.Baseline investigations such as Hemoglobin, Total count, Platelet, C reactive protein and chest x ray was done.Based on the clinical severity and Chest x-ray severitytreatment was initiated with either IVsteroids and or LMWH/Remdesivir.Their fetal Outcomes was closely followed up. The factors such as Maternal mortality, common clinical presentations of COVID pneumonia in pregnancy,frequency of requirement of Ventilatory care, Incidence of Oligohydramnios,Subgroup of individuals with varied modalities of delivery such as instrumentation,LSCS was documented.They were followed up till discharge.Results:108 Patients were included in our study, mean age was 24 years,mean gestational age was 38 weeks,mean duration of hospitalization was 11 days,57% were primigravida,31% had their second pregnancy,13% had GDM, 3% were obese,5% had Anemia complicating pregnancy.66% of the patients were symptomatic at admission,among whom 55% had fever 18% had diarrhea, 12% had dyspnea as the presenting complaint. 57% had less than 25 % lung involvement hence fell into the mild disease category, whereas 43% had more than 25 % lung involvement hence fell in the moderate to severe disease category.NRM mask therapy requirement in the severe disease group was statistically significant.Our patients had a higher prevalence of oligohydramnios when compared to the general population (38%), which didn’t reflect when comparing the mild and severe groups.6 dismal neonatal outcomes were recorded.LSCS rates in our study was 64%. Linear comparison analysis showed that the LSCS rates for Severe disease cohort was significantly higher. Mean CRP was significantly higher in the Severe disease cohort thus serving as a marker of severity.

 
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